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Journal of Scleroderma and Related Disorders最新文献

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Deficiency and altered phenotype of mucosal-associated invariant T cells in systemic sclerosis 系统性硬化症患者粘膜相关不变T细胞的缺乏和表型改变
Pub Date : 2023-11-23 DOI: 10.1177/23971983231209807
Manon Lesturgie-Talarek, Virginie Gonzalez, L. Beaudoin, C. Frantz, Noémie Sénot, Zouriatou Gouda, Camille Rousseau, J. Avouac, A. Lehuen, Y. Allanore
Systemic sclerosis is an autoimmune disease characterized by fibrosis of the skin and internal organs including the lung. Mucosal-associated invariant T cells are innate-like T lymphocytes able to produce various cytokines and cytotoxic mediators such as granzyme B. A large body of evidence supports a role of mucosal-associated invariant T cells in autoimmune disease but more recent reports suggest also a potential role in fibrotic conditions. Therefore, we herein addressed the question as whether mucosal-associated invariant T cells may have an altered profile in systemic sclerosis. Mucosal-associated invariant T cell frequency was analyzed by flow cytometry, using fresh peripheral blood from 74 consecutive systemic sclerosis patients who were compared to 44 healthy donors. In addition, in-depth mucosal-associated invariant T cell phenotype and function were analyzed in unselected 29 women with systemic sclerosis who were compared to 23 healthy women donors. Proportion of circulating mucosal-associated invariant T cells was significantly reduced by 68% in systemic sclerosis compared to healthy donors (0.78% in systemic sclerosis vs 2.5%, p < 0.0001). Within systemic sclerosis subsets, mucosal-associated invariant T cells were reduced in patients with interstitial lung disease (systemic sclerosis-interstitial lung disease) (0.56% vs 0.96% in patients without interstitial lung disease, p = 0.04). Moreover, in systemic sclerosis patients, mucosal-associated invariant T cells displayed an activated phenotype indicated by markedly increased CD69+ mucosal-associated invariant T cell frequency (20% mucosal-associated invariant T cell CD69+ compared to 9.4% in healthy donors, p = 0.0014). Interestingly, mucosal-associated invariant T cells from systemic sclerosis-interstitial lung disease patients had a more pronounced altered phenotype compared to systemic sclerosis without interstitial lung disease with a correlation between mucosal-associated invariant T cells expressing CCR6+ and mucosal-associated invariant T cell frequency (r = 0.8, p = 0.006). Circulating mucosal-associated invariant T cells were reduced and exhibited an activated phenotype in systemic sclerosis patients. This peripheral mucosal-associated invariant T cell deficiency may be related to enhanced apoptosis and/or homing in inflamed tissue, particularly in systemic sclerosis-interstitial lung disease patients.
系统性硬化症是一种以皮肤和包括肺在内的内脏器官纤维化为特征的自身免疫性疾病。大量证据表明,粘膜相关变异 T 细胞在自身免疫性疾病中发挥作用,但最近的报道表明,粘膜相关变异 T 细胞在纤维化疾病中也可能发挥作用。因此,我们在此探讨了粘膜相关不变 T 细胞是否会在系统性硬化症中发生改变的问题。我们使用流式细胞术分析了粘膜相关变异 T 细胞的频率,并将 74 名连续系统性硬化症患者的新鲜外周血与 44 名健康供血者的新鲜外周血进行了对比。此外,研究人员还对未经筛选的 29 名系统性硬化症女性患者与 23 名健康女性供体的粘膜相关不变 T 细胞表型和功能进行了深入分析。与健康供体相比,系统性硬化症患者的循环粘膜相关变异T细胞比例明显降低了68%(系统性硬化症患者为0.78%,健康供体为2.5%,P < 0.0001)。在系统性硬化症亚群中,间质性肺病(系统性硬化症-间质性肺病)患者的粘膜相关变异 T 细胞减少(系统性硬化症患者为 0.56%,无间质性肺病患者为 0.96%,p = 0.04)。此外,在系统性硬化症患者中,粘膜相关变异 T 细胞显示出活化表型,表现为 CD69+ 粘膜相关变异 T 细胞频率明显增加(粘膜相关变异 T 细胞 CD69+ 为 20%,而健康供体为 9.4%,p = 0.0014)。有趣的是,与没有间质性肺病的系统性硬化症患者相比,系统性硬化症-间质性肺病患者的粘膜相关变异T细胞表型发生了更明显的改变,表达CCR6+的粘膜相关变异T细胞与粘膜相关变异T细胞频率之间存在相关性(r = 0.8,p = 0.006)。在系统性硬化症患者中,血液循环中的粘膜相关变异 T 细胞减少并呈现活化表型。这种外周粘膜相关变异T细胞的缺乏可能与炎症组织中凋亡和/或归巢的增强有关,尤其是在系统性硬化症-间质性肺病患者中。
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引用次数: 0
Outcomes in systemic sclerosis patients hospitalized with COVID-19: Insight from the National Inpatient Sample 使用 COVID-19 的住院系统性硬化症患者的疗效:来自全国住院病人样本的启示
Pub Date : 2023-11-21 DOI: 10.1177/23971983231210340
H. Cheema, A. Akhlaq, Biah Mustafa, A. Shahid, M. Ayyan, E. Edigin
COVID-19, a respiratory infection caused by the novel coronavirus SARS-CoV-2, can cause varying degrees of illness ranging from mild respiratory illness to severe respiratory failure. Systemic sclerosis is a chronic autoimmune disease, with an increased prevalence of infections as compared to the general population. In this study, we compare the clinical outcomes and resource utilization for COVID-19 hospitalizations in patients with and without systemic sclerosis. We used the National Inpatient Sample database, 2020, to study the characteristics, morbidity, mortality, cost, and resource utilization among primary COVID-19 hospitalizations with and without systemic sclerosis. There were 1,050,040 patients aged ⩾ 18 years with a diagnosis of COVID-19. Of these, 775 (0.07%) patients had a secondary diagnosis of systemic sclerosis. Although there was no statistically significant difference regarding individual outcomes; in-hospital mortality, vasopressor use, cardiac arrest, acute kidney injury, and disposition to facility were numerically higher in hospitalizations with systemic sclerosis. The composite endpoint of major adverse events was higher in the systemic sclerosis cohort (adjusted odds ratio 1.52, 95% confidence interval: 1.06–2.17, p = 0.022). COVID-19 patients with systemic sclerosis had worse outcomes (i.e. higher composite endpoint of major adverse events) than those without systemic sclerosis. Further studies are needed to establish a better understanding of the relationship between COVID-19 and systemic sclerosis.
COVID-19 是一种由新型冠状病毒 SARS-CoV-2 引起的呼吸道感染,可引起不同程度的疾病,从轻微的呼吸道疾病到严重的呼吸衰竭。系统性硬化症是一种慢性自身免疫性疾病,与普通人群相比,其感染率更高。在本研究中,我们比较了系统性硬化症患者和非系统性硬化症患者 COVID-19 住院治疗的临床结果和资源利用情况。我们利用 2020 年全国住院病人抽样数据库研究了有系统性硬化症和无系统性硬化症的 COVID-19 初次住院患者的特征、发病率、死亡率、费用和资源利用情况。年龄⩾18 岁、诊断为 COVID-19 的患者共有 1,050,040 人。其中,775 名患者(0.07%)被继发诊断为系统性硬化症。虽然单个结果在统计学上没有显著差异,但在系统性硬化症住院患者中,院内死亡率、使用血管加压器、心脏骤停、急性肾损伤和转院治疗的比例较高。系统性硬化症队列中主要不良事件的复合终点更高(调整后的几率比1.52,95%置信区间:1.06-2.17,P = 0.022)。与无系统性硬化症的患者相比,有系统性硬化症的 COVID-19 患者的预后更差(即主要不良事件的复合终点更高)。要更好地了解 COVID-19 与系统性硬化症之间的关系,还需要进一步的研究。
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Journal of Scleroderma and Related Disorders
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